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Postnatal dexamethasone exposure compromises childhood lung function in preemies

12 Jul 2018
The Kangaroo Mother Care (KMC) idea, which originated amid grinding poverty, may be a cheaper and better option than incubators in saving premature babies.

In very premature infants, postnatal exposure to dexamethasone while in the neonatal unit appears to reduce mean lung function at school age, according to a recent study.

Researchers conducted a follow-up study on 179 children who had entered into a randomized trial of two neonatal ventilation methods. Lung function outcomes included forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), forced vital capacity (FVC) and forced expiratory flow at 75 percent (FEF75), 50 percent (FEF50), 25 percent (FEF25) and 25–75 percent (FEF25–75) of the vital capacity.

At least one course of dexamethasone was reported in 28 percent (n=50) of participants, while the remaining had no exposure.

Adjusted multiple regression analysis showed that there were significant differences in favour of the unexposed children in terms of FEF75 (difference, –0.53; 95 percent CI, –0.85 to –0.21; p=0.002), FEF50 (difference, –0.74; –1.05 to –0.43; p<0.001), FEF25 (difference, –0.75; –1.07 to –0.44; p<0.001) and FEF25–75 (difference, –0.70; –1.08 to –0.33; p<0.001).

The same was true for FEV1 (difference, –0.87; –1.24 to –0.51; p<0.001), FVC (difference, –0.38; –0.75 to –0.01; p=0.043), PEF (difference, –10.74; –16.06 to –5.41; p<0.001) and FEV1:FVC (difference, –1.43; –2.09 to –0.78; p<0.001).

The effect of dexamethasone exposure on lung function was confirmed when analysis was based on equivalent percentage of children with abnormal function. For instance, 21 percent vs 43 percent of the nonexposed vs dexamethasone-exposed children had abnormal FEF75 z scores, respectively.

Similar findings were reported for FEF50 (22 percent vs 57 percent), FEF25 (15 percent vs 47 percent), FEV1 (13 percent vs 42 percent) and FVC (8 percent vs 15 percent) z scores.

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Most Read Articles
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 25 Jan 2018
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
26 Dec 2017
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Jairia Dela Cruz, 26 Jun 2018
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Pearl Toh, 20 Mar 2018
Not only does treatment with the PCSK9* inhibitor alirocumab reduces cardiovascular (CV) events along with plunges in LDL-C levels, it was also associated with a reduced risk of all-cause mortality compared with placebo in patient with a recent acute coronary syndrome (ACS) and persistently high cholesterol despite maximal statin therapy, according to top-line results from the ODYSSEY** Outcomes trial.